CMS Price Transparency Data

Blood test, creatinine (kidney)

Facility: Reading Hospital

Billing Code: 82565 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 82565
  • Insurance Median: $20
  • Cash Discount Price: $32
  • vs. Medicare Baseline: 3.91x Medicare
The contracted insurance negotiated median rate for a Blood test, creatinine (kidney) at Reading Hospital is $20. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $32. Compared to the federal Medicare reimbursement reference rate of $5.12, this hospital’s rate is 3.91x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.
Cash / Self-Pay
$32

Average discount available for prompt cash payment at this facility.

Insurance Median
$20

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5.12

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5.12 (100%)
Cash / Self-Pay: $32 (625%)
Insurance Median: $20 (391%)
Cash: $32 (625% of Medicare)
Ins. Median: $20 (391% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5.12 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 391% of the Medicare baseline (a markup of 291%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $5 - $36 98%
Amerihealth Caritas $6 117%
UnitedHealthcare $6 - $9 117%
Upmc $7 - $26 137%
Gateway $8 156%
Geisinger $8 - $31 156%
Health Partners $8 156%
Keystone First $8 156%
Pa Health & Wellness $8 156%
Wernersville State Hospital $8 156%
Aetna $16 - $26 313%
Pma $17 - $20 332%
Lehigh Valley Health Network $19 - $22 371%
Cigna $25 - $28 488%
First Health $26 - $29 508%
Berkshire $32 - $37 625%
Blue Ridge $41 - $47 801%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 420 S 5Th Avenue, West Reading, PA 19611
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals